On the Enlargement of the Normal Congenitally Solitary Kidney

Maluf, N.S.R.

doi:10.1097/00005392-199807000-00133

Cited by 13 publications

(16 citation statements)

References 5 publications

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“…It is not clear if the hyperfiltration in remnant nephrons is so significant, even in children and adolescents, or if the method of GFR estimation we used was not precise enough. However, our observations are in unanimous agreement with those of Maluf [20], who suggested that hyperfiltration in children with CSK is so forced that it exceeds the glomerular filtration of healthy children of the same age. However, clinical observation showed that most of the children with CSK had normal renal function and no proteinuria during their observation in the Paediatric Department.…”

Section: Discussionsupporting

confidence: 93%

“…However, on the other hand, some experimental studies have shown that a solitary kidney has a greater number of renal glomeruli. Maluf showed that congenital solitary kidney is not hypertrophic but hyperplastic and has twice the number of glomeruli as a normal kidney [20]. Also, Glazebrook et al considered that it is likely that solitary kidney can have extra nephrons as a consequence of intrauterine adaptation of nephrogenesis [21].…”

Section: Introductionmentioning

confidence: 99%

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Urinary transforming growth factor beta1 in children and adolescents with congenital solitary kidney

2009

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The aim of the study was to assess urinary transforming growth factor beta1 (TGF beta1) level in children and adolescents with congenital solitary kidney (CSK), depending on estimated glomerular filtration rate (eGFR) and compensatory overgrowth of the kidney. The study group (I) consisted of 65 children and young adults, 0.5-22 years of age (median 10.0 years) with CSK and no other urinary defects. The control group (C) contained 44 healthy children and adolescents, 0.25-21 years old (median 10.3 years). We used an enzyme-linked immunosorbent assay (ELISA) to determine the urinary level of TGF beta1, the Jaffe method to assess creatinine concentration, and the Schwartz formula to estimate GFR. Kidney length was measured while the patient was in a supine position, and overgrowth (O%) was calculated with reference to the charts. Urinary TGF beta1 level in CSK patients was more than twice as high as that in controls (P < 0.05). Also, eGFR in patients with CSK exceeded the values in the control group (P < 0.01). Compensatory overgrowth of the solitary kidney was found (median 19.44%). Urinary TGF beta1 concentration was positively correlated with eGFR (r = 0.247, P < 0.05), uric acid concentration (r = 0.333, P < 0.01), and percentage of overgrowth (r = 0.338, P < 0.01) and body mass index (BMI) centile (r = 0.274, P < 0.05). We concluded that, although proteinuria and progressive renal insufficiency is not observed in patients with CSK during childhood, the renal haemodynamic changes are present and may be a risk factor for impairment of renal function and hypertension in future life.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Urinary transforming growth factor beta1 in children and adolescents with congenital solitary kidney

2009

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“…It is likely that single kidneys can have extra nephrons as a consequence of intrauterine adaptation of nephrogenesis. This is suggested by findings in human beings [8,12] and has been documented by elegant experiments in the lamb [7]. Nevertheless, the high incidence of a contralateral anomaly in patients with MCKD explains the variability of renal anomalies at follow-up [10].…”

Section: Discussionmentioning

confidence: 87%

Renal outcome of children with one functioning kidney from birth. A study of 99 patients and a review of the literature

Dyck

Daniëls

et al. 2007

Eur J Pediatr

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In patients with a single functioning kidney, renal function was assessed at regular intervals over a period of 10 years. Serum creatinine, glomerular filtration rate (GFR), blood pressure, and urinary protein-creatinine ratio were assessed at the age of 2, 5 and 10 years. Between January 1980 and December 2005, 99 such patients were diagnosed in the first year of life. They were divided into three groups: A, patients with multicystic kidney disease and a normal contralateral kidney (n = 36); B, patients with a normal solitary kidney without uropathy (n = 20); and C, patients with obstructive uropathy and one nonfunctioning kidney (n = 43). Serum creatinine levels increased significantly with increasing age in every group. In group C, serum creatinine was significantly elevated compared with group A in all age categories (p = 0.043, p = 0.019, p = 0.001 respectively). Median figures of GFR remained within normal limits over the 10-year period. GFR was significantly lower in group C compared with group A (p = 0.001, p = 0.009, p = 0.019 respectively) and B in all age categories (p = 0.013, p = 0.002, p = 0.016 respectively). There were no changes in blood pressure over time and no differences among the three groups were observed. At the age of 10 years, the patients in group C had a significantly higher median urinary protein-creatinine ratio (p = 0.022) than those in groups A and B. There was also an increasing level of proteinuria with increasing age in group C (p = 0.002). In conclusion, renal function was stable over time in all patients, but children with obstructive uropathy have a lower median GFR and higher serum creatinine level for the whole study period. Hypertension was exceptionally observed in group C, with obstructive uropathy, as was an elevated urinary protein-creatinine ratio.

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“…Moreover, a parenchymal mass may reach 1.8 times the volume of a normal kidney within at least 4 years of life [13]. However, larger CSFKs have twice as many nephrons, and patients show renal hyperfiltration and high serum cystatin-C levels [14].…”

Section: Physiopathologymentioning

confidence: 99%

Are children with congenital solitary kidney at risk for lifelong complications? A lack of prediction demands caution

et al. 2008

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Congenital solitary functioning kidney (CSFK), which develops during embryo or fetal life, means having either one anatomical/functional kidney or two kidneys, one of which does not function. Similar anomalies have been seen in every other organ system and involve a large percentage of newborns. Still, prediction of long-term renal morbidity in congenital functioning solitary kidney is complicated by the great variability of renal and extrarenal phenotypes. Classification of different solitary renal types, whether or not a syndrome, may help to predict the possible evolution of complications; this may be hindered, however, by the gene-environment role during kidney development. Since the risk of renal failure in children with CSFK depends on several variables, it is always advisable to have a precise clinical description at diagnosis. This condition often requires long-term follow-up into adulthood.

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On the Enlargement of the Normal Congenitally Solitary Kidney

Cited by 13 publications

References 5 publications

Urinary transforming growth factor beta1 in children and adolescents with congenital solitary kidney

Urinary transforming growth factor beta1 in children and adolescents with congenital solitary kidney

Renal outcome of children with one functioning kidney from birth. A study of 99 patients and a review of the literature

Are children with congenital solitary kidney at risk for lifelong complications? A lack of prediction demands caution

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